PUNJAB AND HARYANA HIGH COURT AT CHANDIGARH
PANKAJ JAIN, J.
United India Insurance Company Ltd. - Appellant
Vs.
Aagosh Polyfoams Pvt. Ltd. - Respondent
RSA-146-2017 (O&M) and RSA-147-2017 (O&M)
Decided On : 31-07-2025
JUDGMENT :
Pankaj Jain, J.
By way of instant judgment, I intend to dispose off the aforesaid captioned two appeals arising out of the same judgment. With the consent of learned counsel for the parties, RSA No.146 of 2017 is taken as a lead case.
2. Defendant is in second appeal.
3. Plaintiff filed suit for recovery of Rs.1 crore on account of insurance claim. As per plaintiff it is a company registered under the Companies Act, 1956. It is engaged in manufacturing Polyurethane Foam since 1981. There was a fire in the premises of the plaintiff on 20.01.1999. The stocks including raw materials (chemical) finished goods, semi-finished goods and packing materials, plant and machinery and building of the plaintiff company got insured with the appellant vide policy dated 31.12.1999. Cover note was also issued on the same day after the officials of the defendant-insurance company inspected the premises in question and verified the stocks, plant and machinery, and condition of the building. Plaintiff claims to have paid premium of Rs.57,606/-. As per the cover note, plant and machinery of the plaintiff company was valued at Rs.30 lacs, building at Rs.45 lacs and stocks at Rs.50 lacs. The aforesaid three items were accordingly insured for a total sum of Rs.1,25,00,000/- on payment of premium.
4. As per plaintiff, factory premises was again engulfed in fire on 07.04.2000 at 6.30/7.00 p.m. The insurer appointed surveyor to assess the actual loss. The surveyor visited the factory premises on the next day i.e. 08.04.2000. The loss in the premises was photographed by the surveyor. The plaintiff company submitted claim bill on 13.04.2000. Again surveyor inspected the premises on 15.04.2000. On 18.04.2000, list of plant and machinery destroyed was submitted to the surveyor. As per plaintiff, there were two machines in the premises i.e. vertical cutting machine and circular cutting machine which were imported from M/s. Hyma Denmark in the year 1988-1989. After fire of 20.01.1999, the original machines were destroyed and new machines were installed which were of Indian make. The said two machines were destroyed in the fire incident on 07.04.2000. Plaintiff claimed that he is entitled to recover a sum of 84.72 lacs as claimed for the loss in the fire. However, defendant wrongfully repudiated the claim of the plaintiff referring to condition No.1 and 8 of the policy without giving any detail. Plaintiff thus, prayed for recovery of Rs.1 core along with interest.
5. Suit was contested by the defendant. Insurance policy and the payment of premium stands admitted. It was claimed that the amounts mentioned in the cover note were to the extent of risk covered and not as per the actual value of the items. It was further claimed that the bills provided by the plaintiff to show reinstallation of vertical cutting machine and circular cutting machine after first incident of fire were found to be fake. The claim was thus, rightly repudiated considering the report of the surveyors and the other evidence. Defendant contested the claim of the plaintiff of having reinstated the machinery which was damaged in the fire incident in January, 1999.
6. On the basis of the pleadings, Trial Court framed following issues:-
'(1) Whether the plaintiff is entitled for recovery of Rs. 1 crore alongwith interest @ 12% p.a. from the date of decree till realization? OPP
(2) Whether the suit is bad for non-joinder of the necessary parties as Punjab and Sind Bank was not impleaded as party? OPD
(3) Whether the plaintiff has no locus stand? OPD
(4) Whether the suit is barred by limitation? OPD
(5) Relief?
7. Trial Court found that the claim of the insured was not genuine. Trial Court held that S.K. Jain, Director of plaintiff company played foul in forging the documents in respect of purchase of circular cutting machine and vertical cutting machine and declined the claim of the insurer to the said extent. However, decreed the suit filed by the plaintiff to the extent of Rs.56,73,531.32.
8. Defen
The burden of proof in insurance claims lies with the insurer to establish policy violations, and claims cannot be repudiated without substantial evidence supporting such breaches.
Insurers must comply with statutory obligations of disclosure; failure to do so prevents repudiation of claims based on misrepresentations in policy applications.
The duty to disclose material facts runs throughout the continuance of the contract of insurance and it is binding on both parties to the contract.
Point of Law : No fault can be found with the repudiation and the order of Ombudsman affirming the said repudiation and disallowing the claim. [Para 13]
1) Per Sec. 45 of Insurance Act, claim can be repudiated, if it is proved that the assured knowingly and fraudulently suppressed the material facts.2) Contractual duty so imposed on the Insured is su....
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